An almost audible groan rose from the plains of Texas when Bill O’Brien, head coach of the Texans NFL team, told reporters that their three-time defensive end of the year, J.J. Watt, would be out the rest of the season due to necessary surgery on a herniated disc in his back.

Herniated discs can occur in athletes who engage in contact sports, like football, where repetitive stress is put onto the discs in the spine. It can be helpful to imagine that the discs providing shock absorption and cushioning between the vertebrae in your spine are designed a lot like jelly donuts — a strong outer ring of fiber with a softer, more gelatinous substance in the center. When exposed to repeated stress and duress, it’s possible for the outer shell (or annulus) of a disc to weaken and rupture. This, in turn, allows the soft, inner material to leak out of the disc and put pressure on the nerves surrounding it. The now herniated, or slipped disc, disc can cause excruciating pain as well as numbness and tingling in various parts of the body.

Watt initially herniated a disc in the middle of the 2015 season, but played through the condition until finally undergoing surgery to correct the problem in July.

If J.J. Watt’s Original Microdiscectomy Surgery Was Proclaimed As Successful, Why Does He Need To Undergo The Procedure Again?

There are several factors that can play into a recurrent disc herniation, or a herniated disc that returns even after surgery.

For anyone with a disc herniation, there is a slight chance (5-10%) that they will develop another herniated disc at some point in the future and this number is significantly higher for athletes who engage in contact or high impact sports.

One of the main reasons for this is that many athletes are so eager to get back into the game that they often don’t give themselves adequate time to recover. Several prominent world class athletes including Tiger Woods, Peyton Manning and now most recently J.J. Watt have tried to come back too quickly after a microdiscectomy surgery and have caused the problem to recur.

The incision size for a microdiscectomy surgery in the neck or the back is usually only 1 inch or less, so the pain associated with this surgery is often minimal. This being the case, the athlete can be fooled into thinking that he or she is able to return to play after only a month or two. However, what they often don’t realize is that they still have a disc that is worn out or has a hole, regardless of their procedure. A microdiscectomy surgery is designed to remove a disc fragment away from the affected nerve to relieve pressure, but the hole in the disc annulus (the belt of fibers surrounding disc) cannot be repaired surgically. Time needs to pass for the body to seal the hole on its own with scar tissue. This process takes months and does not mature fully for up to 1 year.

Additionally, even after this full healing time, the disc remains weak, much like a worn out tire with a hole that has been patched. This is the reason that Peyton Manning ultimately had to have an anterior cervical discectomywith a fusion that addressed the weak disc by removing it entirely. J.J. Watt will likely require a similar surgery if he continues to play before his disc has fully healed or is too weak to support the spine.

What Does This Mean For Me?

A microdiscectomy surgery is a relatively standard and easy procedure, however a lot of responsibility falls on the patient post-operation. Make sure that you give your body adequate time to heal before returning full-force to the active lifestyle you enjoy. Otherwise you are opening yourself up to recurring pain and additional, more invasive surgery. If you have any questions about your post-op recovery or wondering what you can and cannot do, you should never hesitate to ask your spine doctor.